Definition: Ten most common primary diagnoses for hospital stays among children ages 0-17, excluding childbirth.Ten most common primary diagnoses for hospital stays among children ages 0-17, excluding childbirth, as a percentage of total hospital discharges.

Footnote: County-level data reflect the patient's county of residence, not the county in which the hospitalization occurred. Primary diagnosis is the cause of the hospitalization. Pleurisy is the inflammation of the membrane surrounding the lung. Traumatic injuries include comas and concussions. Examples of metabolic disorders include hyper- and hypothyroidism. Nutritional disorders include a range of conditions such as obesity, diarrhea, anemia, and anorexia. A full list of mental diseases and disorders included can be found at: http://www.cms.gov/icd10manual/fullcode_cms/P0325.html; this list, and data, excludes disorders related to substance abuse. LNE (Low Number Event) refers to data that have been suppressed because there were fewer than 5 cases. Data are excluded for a relatively small number of cases for patients with erroneous birth dates. Data are also excluded from county totals, but included in state totals, for a relatively small number of cases in which county identification is unknown.

Learn More About Hospitalizations

Measures of Hospitalizations on Kidsdata.org

Hospital discharge data include all hospital visits in which the child was admitted for care, but do not include emergency room visits or the births of newborns. A hospital admission occurs when the child's condition is serious enough that the patient requires extended care (i.e., an overnight stay that includes tests, monitoring, and further observation). On kidsdata.org, information on hospital discharges—patients who leave the hospital after a period of care—includes data on sources of payment for services, and the most common primary diagnoses for hospital stays. These data represent the child's county of residence, rather than the location of the hospital.

It is essential that all children have high-quality, accessible, and affordable health care, including hospital stays, when needed. Children with special health care needs, in particular, may require more frequent hospitalizations and specialized, intensive medical care. Ensuring that all children have consistent access to affordable care that is also evidence-based, well-coordinated, family-centered, and provided in the context of a “medical home” can maximize positive outcomes (1, 2).

The hospitalization data on kidsdata.org are based on hospital discharges. Typically, hospital discharge data provide information about patients who are hospitalized (e.g., age, race, gender, and residence), the conditions for which they are hospitalized, the treatments they received, and costs of their care (3). These data can be useful to illuminate trends in public safety and health and can inform injury prevention or disease surveillance (3). For example, asthma is one of the most common diagnoses for hospital stays among children, statewide and nationally (4). Research examining hospital discharge data has found that asthmatic children in neighborhoods with high levels of overcrowding and poverty are more likely to be re-admitted for hospital care than those living in less-disadvantaged areas. Asthmatic children covered by Medicaid instead of private insurance also are more likely to be re-admitted for care (4).

For more information on hospitalizations, see kidsdata.org’s Research & Links section.

2. American Academy of Pediatrics, Council on Children with Disabilities and Medical Home Implementation Project Advisory Committee. (2014).Patient- and family-centered care coordination: A framework for integrating care for children and youth across multiple systems. Pediatrics, 133(5), e1451-e1460. Retrieved from: http://pediatrics.aappublications.org/content/133/5/e1451

In 2014, nearly 235,000 children under age 18 were hospitalized in California, a decrease of about 20% since 2002. Mental diseases/disorders and asthma/bronchitis were the most common reasons for hospitalization among children discharged between 2002 and 2014. Medi-Cal covered expenses for about half (54.3%) of children hospitalized in 2014, and private insurance covered expenses for more than a third (35.3%). Medicare, self-pay, workers compensation, county or other programs for low-income children, other government programs, and other payers covered expenses for the remaining percentage of children hospitalized in 2014. Since 2002, the percentage of children whose costs were covered by private insurers has decreased, while the percentage of children whose costs were covered by Medi-Cal has increased.

Policy Implications

Asthma/bronchitis and mental illness are the two leading diagnoses for children who are hospitalized in California. Asthma can lead to hospitalization when it is severe and not well-controlled. Children of color and low-income children have much higher hospitalization and morbidity rates for asthma than White and higher-income children (1).

According to research and subject experts, policies that could address the leading causes of hospitalization among children—asthma and mental illness—include:

Ensuring that all children have high-quality, accessible, and affordable health care to promote prevention and effective management of asthma and mental illness (1)

Promoting community-wide, integrated interventions to decrease the burden of asthma on high-risk populations, including: strategies to improve health insurance coverage of the uninsured and underinsured; education and outreach; home visiting; and the reduction of asthma triggers in schools, child care centers, homes, and workplaces (1)

Expanding and improving mental health services for youth, including implementing government-funded programs for prevention and early intervention so that disorders can be diagnosed and treated early (2)

Ensuring that mental health insurance benefits are sufficient in amount and scope to be effective (3)